Asthma

Asthma Exacerbation

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Asthma Exacerbation, Exacerbation of Asthma

  • Risk Factors
  • Fatal Asthma attack
  • Classification
  • Asthma Exacerbation Severity
  1. See Asthma Exacerbation Severity Evaluation
  2. Mild Asthma Exacerbation
    1. Dyspnea on exertion (or Tachypnea in young children)
    2. Peak Expiratory Flow (PEF) >70% of predicted
    3. Prompt relief with inhaled Short-acting Beta Agonists
    4. Home management
  3. Moderate Asthma Exacerbation
    1. Dyspnea limits usual activity
    2. Peak Expiratory Flow (PEF) 40-69% of predicted
    3. Relief with frequent inhaled Short-acting Beta Agonists
    4. Office management
      1. Add oral Systemic Corticosteroids
      2. Anticipate 1-2 days of symptoms after treatment onset
  4. Severe Asthma Exacerbation
    1. Dyspnea at rest, limiting conversation
    2. Peak Expiratory Flow (PEF) <40% of predicted
    3. Only partial relief with inhaled Short-acting Beta Agonists
    4. Emergency department management
      1. Hospitalization is likely
      2. Add Systemic Corticosteroids and ipratroprium
      3. Anticipte >3 days of some symptoms
  5. Life Threatening Asthma Exacerbation
    1. Unable to speak, severe Dyspnea with associated diaphoresis
    2. Peak Expiratory Flow (PEF) <25% of predicted
    3. Minimal relief with inhaled Short-acting Beta Agonists
    4. Emergency department stabilization
      1. Intensive care unit admission
      2. Frequent or continuous Albuterol nebs
      3. Add Systemic Corticosteroids and ipratroprium
      4. ABC Management
  • Management
  1. See Asthma Exacerbation Home Management
  2. See Emergency Management of Asthma Exacerbation
    1. Asthma presenting to clinic with Oxygen Saturation at or below 90% may be best managed in emergency department
  3. See Asthma Inpatient Management
  4. See Status Asthmaticus
  • References
  1. (2007) Guidelines for the diagnosis and management of Asthma, NHLBI